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Most bumps beside a nostril piercing are not keloids. A true keloid is uncommon, but it is the one bump that will not fix itself, which is why it is worth knowing the difference before you spend weeks treating the wrong thing.
The short version: an irritation bump stays at the hole and shrinks when you remove the cause. A keloid grows past the hole and keeps growing.
What a nose piercing keloid looks like
The NHS describes keloid scars as raised, hard, smooth and shiny. They can be skin-coloured, pink, red, purple, brown or darker than the skin around them. Unlike other scars, a keloid usually keeps growing for months or years and ends up bigger than the original wound.
On the nose that means a firm, rounded lump that starts at the piercing and spreads outward onto skin that was never pierced. It is often itchy, and it does not respond to the changes that settle an ordinary bump: a better stud, a downsize, a different pillow, saline and patience.
Keloids also tend to appear later than irritation bumps. An irritation bump shows up in the first weeks. A keloid can appear months after a piercing that seemed to be healing normally.
Keloid or irritation bump
| Irritation bump | Keloid | |
|---|---|---|
| Where it sits | At the hole | Spreads past the hole onto normal skin |
| Timing | Days to weeks after the piercing or a knock | Usually months, sometimes after it looked healed |
| Size | Small, often pea-sized or less | Keeps growing, can end up much larger than the wound |
| Feel | Soft or slightly firm, sometimes tender | Firm, rubbery, smooth and shiny, often itchy |
| Colour | Pink or skin-toned | Pink, red, purple or darker than the skin around it |
| When you fix the cause | Shrinks over weeks | No change, or keeps growing |
| What it needs | Remove the cause | A dermatologist |
The nose piercing bump guide covers the seven causes of an irritation bump and the protocol that clears one. The keloid guide explains keloids across every piercing, and piercing bump vs keloid compares all the kinds of bump side by side.
A bump inside the nostril
A lump inside the nostril, where the flat disc sits, is rarely a keloid. It is usually pressure: a post that is too short, a disc that is too large, or a stud that was never downsized. The fix is a piercer checking the fit, not a dermatologist.
Who is more likely to get a keloid
Keloids are not caused by bad aftercare. They are a difference in how some people’s skin repairs itself. The NHS says you are more likely to develop them if you:
- Are aged 10 to 30.
- Are of south Asian, Chinese, African Caribbean or Black African origin.
- Have had a keloid before.
- Are pregnant.
A family history also raises the risk considerably. None of this is a reason not to get pierced, but it is a reason to raise it with a dermatologist beforehand and to know what to watch for.
What to do first
- Check the usual causes. Look at the jewelry, your sleeping side, and anything touching the nose. A nose bone, an L-shape or a hoop worn too early can cause bumps. See nose piercing jewelry.
- Remove the cause and wait. Give a nostril bump two to eight weeks with saline twice a day and nothing else, as the bump guide explains.
- Watch what it does. A bump that shrinks was never a keloid. One that is still growing after three months, or that has spread beyond the original hole, needs a dermatologist.
- Treat heat, thick coloured discharge or a fever as infection. That is a doctor the same day, with the jewelry left in. See infected nose piercing.
What a dermatologist can do
Keloid treatment is a course, not a single appointment. According to the American Academy of Dermatology:
- Corticosteroid injections are often part of the plan, and between 50 and 80 percent of keloids shrink after being injected.
- Silicone gel sheets may help flatten a keloid.
- Cryotherapy, freezing the keloid, can reduce its hardness and size, and works best on smaller ones.
- Laser treatment can reduce the height and fade the colour.
- Surgery on its own is followed by the return of nearly all keloids, so it is normally combined with other treatment such as injections or radiation.
The NHS advises seeing a GP if you think you have a keloid and it is bothering you. A dermatologist can tell you what the lump is and which of these options suit it.
What not to try
- Cutting, popping, picking or tying it off. Any injury to a keloid is a new wound in skin that forms keloids, and it is the most reliable way to end up with a bigger one.
- Tea tree oil, aspirin paste and other home remedies. They do nothing for scar tissue and often irritate skin. The nostril guide explains why they are also a common reason an ordinary bump will not settle.
- Harsh products. The Association of Professional Piercers advises against alcohol, hydrogen peroxide and ointments on a piercing.
- Cheap jewelry. Nickel and plated metal can irritate the piercing and keep a bump going. See the materials guide.
The piercing, and piercing again
Ask the dermatologist whether to keep or remove the jewelry. Taking it out lets the channel close, but it does not remove scar tissue that has already formed.
If you have formed a keloid before, the chance of another is high. Talk to a dermatologist before any new piercing, choose an experienced piercer, and agree a plan to treat the first sign of a bump early. Some people go ahead with that plan and some decide the risk is not worth it.
If you have not been pierced yet
If keloids run in your family, or you have had one before, raise it with a dermatologist first. If you go ahead, a fitted flat-back stud, an on-time downsize, and no sleeping on the piercing help prevent bumps, which are the more likely problem.
Not medical advice
This page is educational. If a bump is growing, spreading past the piercing or bothering you, see a dermatologist. If a piercing is hot, has spreading redness or thick coloured discharge, or you have a fever, see a doctor the same day.
Frequently asked questions
Is my nose piercing bump a keloid?
Probably not. Most bumps beside a nostril piercing are irritation bumps caused by jewelry, pressure or knocks, and they settle once the cause is fixed. A keloid is a firm, shiny scar that keeps growing beyond the piercing hole, usually appears later, and does not shrink on its own.
How can I tell a keloid from a nose piercing irritation bump?
By what it does. An irritation bump stays at the hole, stays small and shrinks when you remove the cause. A keloid spreads onto skin that was never pierced, keeps growing for months, and is firm and shiny. The test is growth beyond the original hole.
How common are keloids on nose piercings?
Much less common than ordinary irritation bumps. A keloid can follow any skin injury, including a body piercing, according to the NHS, but the great majority of bumps beside a nostril piercing are mechanical and fixable.
Will a nose piercing keloid go away on its own?
No. The NHS says you cannot get rid of a keloid, though treatment can improve how it looks. An irritation bump or a hypertrophic scar can settle by itself once the cause is removed, which is the main reason the difference matters.
How is a nose piercing keloid treated?
By a dermatologist. The American Academy of Dermatology lists corticosteroid injections, which shrink between 50 and 80 percent of keloids, plus silicone gel sheets, cryotherapy and laser. Surgery on its own is followed by a return of nearly all keloids, so it is usually combined with other treatment.
Should I take my nose piercing out if I think it is a keloid?
Get it assessed first. Removing the jewelry lets the channel close but does nothing to scar tissue that has already formed. Do not try to cut, pop or pull a keloid: any injury to one is a fresh wound in skin that forms keloids.
Sources
- NHS - Keloid scarshttps://www.nhs.uk/conditions/keloid-scars/
- American Academy of Dermatology - Keloid scars: diagnosis and treatmenthttps://www.aad.org/public/diseases/a-z/keloids-treatment
- Association of Professional Piercers - Troubleshootinghttps://safepiercing.org/troubleshooting/
This article is for education only and is not medical advice. If a piercing is hot, swollen, spreading redness, oozing yellow or green discharge, or you have a fever, see a doctor today.